Study of weight loss intervention to find an effective strategy for obesity management and the TARGET of weight loss amount for reducing health disorders (SLIM-TARGET): a randomized controlled trial.
Masaya Koshizaka, Hidetaka Yokoh, Ko Ishikawa et al.
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In 30 seconds
This randomized controlled trial compared standard with intensive weight-loss treatment in 294 participants with overweight or obesity and six obesity-related conditions. The 12-month weight-loss targets were ≥3% and ≥7%, respectively; intensive care added frequent nutritional guidance, enhanced diet and exercise therapy, and pharmacotherapy. Weight loss was -2.5% with intensive treatment and -1.7% with standard care, with no significant difference in the primary outcome of weight loss plus improvement in at least two disorders. However, remission of health disorders was more frequent with intensive treatment: 16.9% versus 6.2% (adjusted odds ratio 3.079; 95% CI 1.075-8.823; p = 0.036).
Key findings
- The primary outcome did not differ significantly; 12-month weight loss was -2.5% with intensive treatment and -1.7% with standard care.
- Remission of health disorders occurred in 16.9% versus 6.2% (adjusted odds ratio 3.079; 95% CI 1.075-8.823; p = 0.036).
- Visceral fat reduction was greater with intensive treatment (-20.46 cm 2 vs. -8.9 cm 2 ; p = 0.039).
- At least 60% of participants in both groups improved in one or more disorders; intensive treatment also improved early blood pressure control and treatment motivation at 24 months.
Why it matters
The findings suggest that benefits of a more intensive obesity-management programme may extend beyond achieving a prespecified weight-loss target. Disorder remission and visceral fat reduction improved despite modest weight loss and no significant difference in the primary outcome. This highlights the value of assessing health outcomes alongside weight change, while the trial does not establish that intensive treatment is superior on its primary endpoint.
What to keep in mind
The intensive group did not achieve its ≥7% weight-loss target, and the primary outcome showed no significant between-group difference.